If a mom hits a hurdle in her breastfeeding, it doesn’t mean she needs to change to bottle feeding. Here are a few options for dealing with common problems experienced during early days and weeks of breastfeeding.

Baby spluttering at the breast

Some moms have milk that lets down really fast or flows so quickly that baby gags on it, brings up lots after feeds and may even do frothy green nappies.

What many say helps is to lean back propped on pillows, put baby's head at their breasts, stomach against their stomach and legs pointing towards moms legs.

This lets gravity help your flow slow down a bit. If this on its own doesn't make feedings easier, some mothers find that when baby comes off the first breast, they offer that same breast again for two or three feeds, before using the other breast for a few feeds.

This can be particularly helpful in the early morning hours. This helps milk supply adjust down to what baby needs.

Baby falling asleep at the breast

Sometimes a newborn baby has a little suck and then falls asleep without actually getting the milk to let down.

To keep baby interesting at the breast, it can help to use breast compressions to keep the milk flowing.

When the sound of swallowing stops, let go for a quick count of five and then compress again.

When there is no more swallowing, swap to the other breast and repeat. You can continue to swap from breast to breast like this (it's called switch nursing) until there is no more swallowing.

If baby is still not satisfied or sleeping, or is only gaining weight slowly, some of your own expressed milk could be offered by cup or spoon or syringe or eye dropper after a breastfeed.

Do note that some babies feed quite quickly, so if your baby only feeds for 5 or 10 minutes, but you can hear swallowing and baby is de-latching or falling asleep satisfied and gaining weight well, then there is no need to do anything about this.

Sleepy baby

A full term, healthy baby needn't be woken for feeds. However, if baby is jaundiced or premature or has low weight gain or insufficient wet (at least five or six a day) and dirty nappies (two to five, each the size of a R5 coin) and is going past 2 - 3 hours without a feed, then offering a feed when baby is in a light sleep can be helpful.

It is easiest to wake baby when eyes are fluttering under the lids and arms are moving. A little milk squirted into the mouth can sometimes get baby interested too.

Baby feeding for a long time:

Some babies feed quickly and some babies feed slowly. Both are quite normal.

If a baby is only allowed to feed for a set number of minutes, it can lead to low weight gain and lowering milk supply, so its best to let baby feed as long (or short) as they want to. How long they feed for really only tells you how fast your milk flows.

If baby regularly feeds for more than an hour, using breast compressions can help. If nappy output is low, expressing and supplementing with your own milk by dropper or spoon or cup can help.

As baby gets bigger they will suck more strongly and even a baby who fed for 45 minutes to an hour will feed much more quickly. Their little mouths also get bigger making feeding a bit faster.

Painful nipples

There are a number of reasons nipples can hurt, however, sore nipples are not a normal part of breastfeeding, it means that there is a problem that should be resolved. In the first few days, nipples can be a bit tender, and the start of feeds can be a bit uncomfortable as the tissue stretches, but if it is toe curlingly sore or goes on longer than this or your nipples crack – something needs fixing.

Baby’s mouth might not be open wide enough so the nipple is not far back enough in the mouth, or perhaps you need more cushions to prop baby into a more comfortable position so that they’re close enough and baby isn’t hanging off the edge. In rare cases, baby could have a tongue tie or an upper lip tie. This comes right by itself over time, however, if it is causing a feeding problem, then, once your clinic sister has confirmed the problem, seeing an ENT for treatment can help. Some mothers may also get thrush on their breasts and in baby’s mouth which can be painful. The clinic sister can check for this and your GP can assist you with treatment.

If you want to breastfeed and experience problems, there is help available:

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